A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services: 1994–2014

Sandeep Reddy, Peter Jones, Harsha Shanthanna, Raechel Damarell, John Wakerman

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.
Original languageEnglish
Pages (from-to)81-105
Number of pages25
JournalINTERNATIONAL JOURNAL OF HEALTH SERVICES
Volume48
Issue number1
Early online date2017
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint Dive into the research topics of 'A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services: 1994–2014'. Together they form a unique fingerprint.

Cite this